Liu Jian, Zhang Miaomiao, Li Bin, Wang Jianrong
Department of Ophthalmology, The Second People's Hospital of Jinan, No. 148 Jingyi Road, Jinan 250001, China.
J Ophthalmol. 2017;2017:7947854. doi: 10.1155/2017/7947854. Epub 2017 Feb 26.
. To evaluate primary trabeculectomy with adjunctive mitomycin-C (MMC) in diabetic patients without retinopathy with primary angle-closure glaucoma (PACG). . This is a retrospective case series comparison. . This retrospective trial compared outcomes of 88 eyes that underwent trabeculectomy in patients with diabetes mellitus (DM) without retinopathy and in 97 patients without DM. . In this study, the intraocular pressure (IOP), visual acuity, visual field, and postoperative complications were compared between the two groups. Qualified surgical success is defined as an IOP between 6 and 18 mmHg with or without topical antiglaucoma medication. . After a follow-up of 5 years, the IOP decreased from a mean basal IOP of 27.8 ± 7.3 mmHg to 15.0 ± 5.6 mmHg in the DM group and from 27.3 ± 6.0 mmHg to 12.4 ± 5.3 mmHg in the control group. The mean number of antiglaucoma medications was 3.4 ± 1.3 and 3.3 ± 1.2 preoperatively ( = 0.587) whereas it was 1.7 ± 1.5 and 1.1 ± 1.4 at the 5-year follow-up ( = 0.049). The 5-year qualified surgical success rates were 42.9% and 65.4% for both groups ( = 0.046; log-rank test). Encysted blebs were seen in 21 (23.9%) patients in the DM group and in 12 (12.4%) patients in the control group ( = 0.041). . PACG patients with DM without retinopathy undergoing primary trabeculectomy with MMC may have a lower long-term surgical survival rate compared with patients without DM.
评估在无视网膜病变的糖尿病患者中，小梁切除术联合丝裂霉素C（MMC）治疗原发性闭角型青光眼（PACG）的效果。这是一项回顾性病例系列对照研究。该回顾性试验比较了88例无视网膜病变的糖尿病（DM）患者行小梁切除术的眼部情况与97例非糖尿病患者的情况。在本研究中，比较了两组的眼压（IOP）、视力、视野及术后并发症。合格的手术成功定义为眼压在6至18 mmHg之间，无论是否使用局部抗青光眼药物。随访5年后，DM组眼压从平均基础眼压27.8±7.3 mmHg降至15.0±5.6 mmHg，对照组从27.3±6.0 mmHg降至12.4±5.3 mmHg。术前抗青光眼药物的平均使用数量在两组分别为3.4±1.3和3.3±1.2（P = 0.587），而在5年随访时分别为1.7±1.5和1.1±1.4（P = 0.049）。两组的5年合格手术成功率分别为42.9%和65.4%（P = 0.046；对数秩检验）。DM组21例（23.9%）患者出现包裹性滤泡，对照组12例（12.4%）患者出现包裹性滤泡（P = 0.041）。与非糖尿病患者相比，无视网膜病变的DM患者行小梁切除术联合MMC治疗PACG的长期手术成功率可能较低。
